No abstract available.
Humans

Unfortunately, we have poor knowledge of medical technology in North Korea. This study has thus attempted to identify the level and status of medical technology development through analyzing the contents of medical textbooks currently in use. This study has assumed that three factors are influencing the level and status of medical technology in a society ; the level of socio-economic development in general, the level of scientific technology revolution and health policy. Forty textbooks are collected for this purpose. The main findings are summarized as follows: 1) North Korea has strengths in that (1) its herb drugs, which are in a broad use, are cheaper, more safe and more attainable than bio-equivalent chemical ones, and (2) the development of its medical technology was carried out with emphasis on the practical and basic health needs. 2) North Korea has weaknesses in that (1) its medical diagnostic method largely depends on manual procedures, (2) the R & D investment in the development of chemical drugs, especially antibiotics, is very small, (3) the amount of medical equipments is in a absolute shortage, and (4) the medical technology is destitute of specialty, caused mainly by the overemphasis on Juche-Uihak or herb medicine. 3) Medical technology has two faces, positive and negative so that it cannot be successfully evaluated by one. It eventually acts a positive function for public health through developments of drug, equipment and new medical treatment method. But it is also true that it has negative effects such as the dehumanization of high cost medical technology, cost hike due to over-investments in expensive equipments, and the absence of wholistic care from overspecialization. 4) We have to consider economic status and the social needs of medical care in order to evaluate the medical technology of a society. It is also the ease with North Korea. A whole picture of the North Korean medical technology could be understood only if further comprehensive studies of medical technology are to be carried out for North Korea.
Anti-Bacterial Agents ; Dehumanization ; Democratic People's Republic of Korea* ; Health Policy ; Herbal Medicine ; Investments ; Public Health

No abstract available.
Child* ; Humans

BACKGROUND: The etiology of Behçet's disease(BD) is not yet certain, and various hypotheses are suggested. In order to determine the role of dietary intake behavior in the pathogenesis of BD, we analyzed BD patients by questionnaire regarding their personal, social, and economic characteristics, and dietary intake behavior. METHODS: A series. of 79 patients who were registered at the Behçet's Disease Specialty Clinic at Severance Hospital, Yonsei University College of Medicine, Seoul, Korea were studied. The patients were classified and the data from the patients were analyzed according to the revised Japanese criteria. RESULTS: All patients except for suspected type patients took an average amount of nutrition close to the Korean Recommended Dietary Allowance(RDA). However, on the whole, the amount of consumption of Vitamin B2 and C was low and in the case of females, the consumption of Ca and Fe was makedly insufficient in accordance with the Korean RDA. In case of the level of dietary and serum zinc, there was no significant difference in patients or among groups. CONCLUSION: Since the consumption of some vitamins and minerals of patients were low, the behavior of dietary intake of BD patients which is considered to have a possible role in development of disease should be studied further.
Asian Continental Ancestry Group ; Female ; Humans ; Korea ; Minerals ; Miners ; Riboflavin ; Seoul ; Vitamins ; Zinc

Objective: Cortical iron deposition has recently been shown to occur in Alzheimer’s disease (AD). In this study, we aimed to evaluate how cortical gray matter iron, measured using quantitative susceptibility mapping (QSM), differs in the clinical cognitive impairment spectrum. Materials and Methods: This retrospective study evaluated 73 participants (mean age ± standard deviation, 66.7 ± 7.6 years;52 females and 21 males) with normal cognition (NC), 158 patients with mild cognitive impairment (MCI), and 48 patients with AD dementia. The participants underwent brain magnetic resonance imaging using a three-dimensional multi-dynamic multi-echo sequence on a 3-T scanner. We employed a deep neural network (QSMnet+) and used automatic segmentation software based on FreeSurfer v6.0 to extract anatomical labels and volumes of interest in the cortex. We used analysis of covariance to investigate the differences in susceptibility among the clinical diagnostic groups in each brain region.Multivariable linear regression analysis was performed to study the association between susceptibility values and cognitive scores including the Mini-Mental State Examination (MMSE). Results: Among the three groups, the frontal (P < 0.001), temporal (P = 0.004), parietal (P = 0.001), occipital (P < 0.001), and cingulate cortices (P < 0.001) showed a higher mean susceptibility in patients with MCI and AD than in NC subjects. In the combined MCI and AD group, the mean susceptibility in the cingulate cortex (β = -216.21, P = 0.019) and insular cortex (β = -276.65, P = 0.001) were significant independent predictors of MMSE scores after correcting for age, sex, education, regional volume, and APOE4 carrier status. Conclusion Iron deposition in the cortex, as measured by QSMnet+, was higher in patients with AD and MCI than in NC participants. Iron deposition in the cingulate and insular cortices may be an early imaging marker of cognitive impairment related neurodegeneration.

Mechanical obstruction of the common hepatic duct includes the following causes; choledocholithiasis, sclerosis, cholangitis, pancreatic carcinoma, cholangiocarcinoma, postoperative stricture, primary hepatic duct carcinoma, enlarged cystic duct lymph nodes, and metastatic nodal involvement of the porta hepatis. Partial mechanical obstruction of the common hepatic duct caused by impaction of stones and inflammation surrounding the vicinity of the neck of the gallbladder had been reported on the “syndrome del conducto hepatico” in 1948 by Mirizzi. Nowadays, this disease was named by Mirizzi syndrome. Mrizzi syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a variant of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease. A 71-year-old man was admitted with a four-day history of right upper quadrant abdominal pain. Past medical history was unremarkable. On physical examination, the patient had a temperature of 38℃, icteric sclera and right upper quadrant tenderness. Pertinent laboratory findings included WBC 18,000/cm3; albumin 2.6 g/dl (normal 0-1) with the direct bilirubin, 4.4 mg/dl (normal 0-0.4). Ultrasonography revealed a dilated extrahepatic biliary tree. ERCP showed that the superior margin was angular and more consistent with a calculus causing partial CHD obstruction (Mirizzi syndrome). At surgery a diseased gallbladder containing calculi was found. In addition, there was two calculi partially eroding through the proximal portion of the cystic duct and compressing the common hepatic duct. A cholecystectomy and excision of common bile duct was performed, with Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful.
Abdominal Pain ; Aged ; Biliary Tract ; Bilirubin ; Calculi ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Choledocholithiasis ; Common Bile Duct ; Constriction, Pathologic ; Cystic Duct ; Cytochrome P-450 CYP1A1 ; Gallbladder ; Gallstones ; Hepatic Duct, Common ; Humans ; Inflammation ; Jaundice, Obstructive ; Lymph Nodes ; Mirizzi Syndrome* ; Neck ; Physical Examination ; Sclera ; Sclerosis ; Ultrasonography

The complications and the patients' attitude after transrectal systematic sextant biopsy of the prostate were evaluated by the questionnaire retrospectively. One hundred and sixty one of 211 men over 50 years old responded to the questionnaire. Transrectal sextant biopsy of the prostate under the finger guidance was performed by two doctors using Biopty Gun. The first 85 men (group A) received glycerin enema and oral administration of norfloxacin 30 minutes before the biopsy and norfloxacin was administered once again two to three hours after the biopsy. The other 126 men (group B) received the same procedures but the enema was performed using mixture of glycerin & betadine solution and the norfloxacin was administered 30 minutes before and for 3 days after the biopsy. Benign prostatic hyperplasia was diagnosed pathologically in 190 cases(90.1%) and prostate cancer in 8 cases(3.8%). No complication was less found in group A(23.4%) than in group B(40.5%)(P<0.05). Reported complications were perineal tenderness (group A: 42.9%,group B: 31.0%), hematuria (group A: 32.5%, group B: 34.5%), hemospermia (group A: 29.99%, group B: 19.0%), rectal bleeding (group A: 11.7%, group B: 11.9%), fever (group A: 15.69%, group B: 6.0%) and scrotal tenderness (group A: 2.6%, group B: 3.6%). In group A sepsis was developed in one case. Perineal tenderness lasted for 6.7 days in group A 5.1 days in group B. Hematuria was observed for 9.7 days in group A, 7.5 days in group B. Hemospermia was seen for 28.1 days in group A, 13.7 days in group B. Average duration of complications was shorter in group B (P<0.05). The better they understand the procedure of the biopsy, the less pain and the more satisfaction they experience. the rate of failure in obtaining tissue cores was 6.2%. If the doctor experiences more than about 120 cores of the tissue, the learning curve of success rate to obtain the proper specimens arrives to its plateau. In conclusion, the incidence of complications may be decreased by using appropriate pretreatment, especially adequate amount of antibiotics. Patient education is one of the most important steps to reduce the complications of this invasive technique.
Administration, Oral ; Anti-Bacterial Agents ; Biopsy* ; Enema ; Fever ; Fingers* ; Glycerol ; Hematuria ; Hemorrhage ; Hemospermia ; Humans ; Incidence ; Learning Curve ; Male ; Middle Aged ; Norfloxacin ; Patient Education as Topic ; Povidone-Iodine ; Prostate* ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Surveys and Questionnaires ; Retrospective Studies ; Sepsis

We investigated population densities of mosquitoes infected with sporozoites in three highly epidemic areas of Josan-ri and Jangpa-ri (Paju City) and Dongjung-ri (Yeoncheon County) in Korea. Anopheline mosquitoes were collected from both indoors and outdoors by human baiting collection method during the period of the first week of June to the second week of September 1999. Total 13,296 female mosquitoes were collected and 8,650 (65.1%) were Anophelines. Thirty seven percent (3,199) of the Anopheline mosquitoes were captured outdoors and 63.9% (5,531) indoors. Employing a sandwich enzyme-linked immunosorbent assay (ELISA), we analyzed a total of 7,820 Anopheline mosquitoes and found that 7 Anopheline mosquitoes were infected with sporozoites. The positive rate in Josan-ri was 0.14% (5/3,500) and 0.15% (2/1,370) in Jangpa-ri. The total positive rate in all three surveyed areas was 0.09% (7/7,820). The mosquitoes infected with the sporozoites were detected on June 28th (n=2), July 5th (n=1), July 19th (n=1), August 9th (n=1), September 6th (n=1), and the last one on September 13th (n=1). They were all classified as Anopheles sinensis, which showed positive reaction in ELISA test. Therefore it might be concluded that A. sinensis plays an important role in re-emerging malaria transmission in Korea.
Animals ; Culicidae/*parasitology ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Korea/epidemiology ; Malaria, Vivax/epidemiology/parasitology/transmission ; Plasmodium vivax/*isolation & purification ; Support, Non-U.S. Gov't

PURPOSE: The purpose of this study was to identify the relationship among family stress, family meaning and family adaptation of families with high risk neonates. METHOD: The date was collected on the basis of self- report questionnaires (August 2004 to March 2005); Tow-hundred twelve parents, who had high risk neonates in C hospital's neonatal intensive care unit, participated on request. RESULTS: Family sense of coherence, family meaning, social support, family stress, marital communication and patient condition had a significant, direct effect on family adaptation. Family cohesion, religion, confidence in the health professional, and length of stay had a significant, direct effect on family meaning. CONCLUSION: The results of this study suggest the consequences associated with high risk neonates may be alleviated by a family support intervention designed to improve parental communication skills as well as to maintain family cohesiveness. Medical care could also encourage more emotional support of parents towards their neonate.
*Adaptation, Psychological ; Adult ; Family/*psychology ; Family Relations ; Female ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal/*psychology ; Male ; Parents/*psychology ; Predictive Value of Tests ; Questionnaires ; Social Support ; *Stress, Psychological

Purpose: The coronavirus disease 2019 (COVID-19) outbreak has significantly impacted the diagnosis and treatment of breast cancer. Our study investigated the change in diagnosis and treatment of breast cancer with the progress of COVID-19 pandemic. Materials and Methods: The study group comprised 6,514 recently diagnosed breast cancer patients between January 1, 2019, and February 28, 2021. The patients were divided into two groups: pre–COVID-19 period (3,182; January 2019 to December 2019) and COVID-19 pandemic period (3,332; January 2020 to February 2021). Clinicopathological information related to the first treatment after breast cancer diagnosis was retrospectively collected and analyzed in the two groups. Results: Among the 6,514 breast cancer patients, 3,182 were in the pre–COVID-19 period and 3,332 were in the COVID-19 pandemic period. According to our evaluation, the least breast cancer diagnosis (21.8%) was seen in the first quarter of 2020. The diagnosis increased gradually except for the fourth quarter in 2020. While early-stage breast cancer was diagnosed 1,601 (48.1%) during the COVID-19 pandemic (p=0.001), the number of surgical treatments increased 4.6% (p < 0.001), and the treatment time was slightly shorter 2 days (p=0.001). The breast cancer subtype distribution was not statistically different between the pre–COVID-19 and COVID-19 period groups. Conclusion In the early stages of the pandemic, the number of breast cancer cases temporarily decreased; however, they stabilized soon, and no significant differences could be identified in the diagnosis and treatment when compared to the period before the pandemic.